Gary Ellenbogen, D.D.S.
NPI 1770653495ActiveIndividual· Dentist, General Practice· Vienna, VA
Dentist, General Practice (D.D.S.) in Vienna, Virginia, licensed in VA, with an NPI issued in November 2006. Enrolled in Medicare as order and referring only - dentist.
Overview
| NPI | 1770653495 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.D.S. |
| Sole proprietor | No |
| NPI issued | Nov 9, 2006 |
| Last updated in NPPES | Sep 11, 2013 |
| Reactivated | Sep 11, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 5562 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Dentist (VA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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